Key result
Doxycycline, methylprednisolone, and furosemide improve symptoms in a case of Rocky Mountain spotted fever-associated myocarditis.
Why the study?
Atypical presentations of Rocky Mountain spotted fever can lead to life-threatening complications such as myocarditis, requiring clinical vigilance.
Case Report (n=1)
This case highlights the importance of maintaining a broad differential diagnosis for atypical presentations of infections like Rocky Mountain spotted fever to prevent life-threatening complications such as myocarditis.
Consider RMSF in unexplained myocarditis; single case leaves optimal regimen open to prospective study.
A previously healthy 23-year-old enlisted man presented for 2 days of fever, gastrointestinal symptoms, cough, and disseminated rash involving the palms and soles. Initial evaluation revealed leukocytosis, elevated liver enzymes, and hyponatremia. Despite antibiotic therapy for pneumonia, his condition worsened, with development of bilateral pleural effusions and myocarditis. After treatment with doxycycline, methylprednisolone, and furosemide, his symptoms improved. He completed a 7-day antibiotic course. Rocky Mountain spotted fever serology was positive 5 weeks after symptom onset. This case highlights the importance of maintaining a broad differential diagnosis and remaining vigilant for atypical presentations of infections to prevent life-threatening complications.
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Zuberi et al. (2025) conducted a case report in Rocky Mountain spotted fever-associated myocarditis (n=1). Doxycycline, methylprednisolone, and furosemide was evaluated on Clinical improvement. Treatment with doxycycline, methylprednisolone, and furosemide led to symptom improvement in a 23-year-old man with Rocky Mountain spotted fever-associated myocarditis.
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